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In-Plane vs Out-of-Plane Approach

Two approaches can be taken for any nerve block, the In-Plane approach or the Out-of-Plane approach. With the in-plane approach, the needle enters the skin at the side of the probe. The needle traverses the plane of ultrasound and the whole shaft is visualized as it progresses towards the target. With the Out-of-Plane approach, the needle enters the skin away from the probe, and is aimed at the plane of sound. With this approach just the needle tip is visualized and the remainder of the needle is off screen. Although both viable options, the In-Plane Approach will be used in the examples as it shows a larger needle artifact which is easier to track.